This proposal stems from an examination of case records at the Worcester State Hospital, 1840-1860. Initially 4,000 cases for the period described were studied to determine the best method of analyzing the relationship between observed deviant behavior and the social origins of patients. A coding procedure was developed which would identify the specific acts perceived by superintending physicians as significant components of pathology. Similar coding procedures were established for information on sex, age, national origin, occupation, residence, commitment procedures, and premonitory signs. This is a preliminary step for a computer based reconstruction of diagnosis, treatment, and prognosis. This proposal requires the development of a program to determine the association of changing perceptions of aberrant behavior, designation of diagnostic categories and treatments, and various indicators of the social origins and characteristics of patients. The study will permit systemative evaluation of changes in psychiatric practice as it reflects and responds to various contingencies which differentiate patients over time. Symptoms will be reassembled through the computer to determine if shifting patterns of pathology can be identified and if these patterns can be systematically associated with specific groups. At the same time research in the published and manuscript writings of superintendent physicians will provide further understanding of the experience and theory which supported diagnosis, therapy, prognosis, and prophylaxis. The proposal will permit coding and analysis of approximately 16,000 case records from Worcester Hospital (1833-1860), Hartford Retreat (1824-1860), Maine Insane Asylum (1840-1860), Butler Hospital (1847-1860), and Pennsylvania Hospital for the Insane (1841-1860). The construction of a retrospective clinical model has implications for the history of medicine, and also for contemporary research on clinical procedures and institutional care in cross-cultural settings.